Prevalence and factors associated with hypertension among persons living with HIV in Mombasa County, Kenya

Abstract

Background: Hypertension is a non-communicable disease defined as blood pressure greater than 140/90 millimeters of mercury. The global prevalence of hypertension among Persons Living with HIV(PLHIV) was estimated to be 35% in 2021. The overall prevalence of hypertension in Kenya has been estimated to be at 24% and the prevalence among PLHIV during the same year was 18.9% in a study done in central Kenya. However, the factors associated with hypertension among PLHIV in Mombasa County are unknown. Objectives: To determine the prevalence of hypertension, describe factors associated with hypertension, and knowledge, attitude, and practices related to hypertension among PLHIV in Mombasa County. Methods: A cross-sectional study design was used among adult patients on HIV follow-up at Comprehensive Care Clinics in Mombasa County. Systematic sampling was used to identify the sample size of 235. Questions derived from validated questionnaires were used for collection of quantitative data. Frequencies and proportions were calculated for the categorical variables and measures of central tendency and dispersion for continuous variables. Bivariate analysis was done by calculating the prevalence ratio (PR). Multivariate analysis was done by calculating the adjusted Prevalence Ratio (aPR). Knowledge, attitude, and practice scores were computed where higher scores suggested higher knowledge, positive attitudes toward hypertension, and better hypertension prevention practices. Results: A total of 235 participants were enrolled. The majority (71%) of the participants were females. The mean age of the participants was 42.8 (±10.7) years with the age group 35–44 years having the largest proportion at 35%. The prevalence of hypertension was 25%. The factors associated with hypertension were Body Mass Index between 25 and 29.9 [aPR 2.41 (C. I 1.30 – 4.42)], BMI greater than 30 [aPR 3.37 (C. I 1.69–6.73)] and use of a tenofovir-based regimen [aPR 0.32 (C.I 0.17 – 0.60)]. There was good knowledge and attitudes toward hypertension. Good practices were reported in both hypertensive and non-hypertensive participants. Conclusion: There was a higher prevalence of hypertension compared to previous studies. Participants with a high BMI had a higher prevalence ratio of hypertension and participants on tenofovir-based regimens had a lower prevalence ratio of hypertension. The participants were knowledgeable about hypertension, had a positive attitude towards hypertension, and carried out fair hypertension prevention practices. Recommendations: We recommend that weight monitoring and management as well as tenofovir-based therapy should be utilized among PLHIV to reduce their risk of developing hypertension.